Cleft lips and palates are some of the most common birth anomalies affecting children worldwide. The incomplete development of the upper lip (cleft lip) and roof of the mouth (cleft palate) can occur both individually, or simultaneously. These conditions vary in severity and may include one or both sides of the mouth.
Clefts occur early in the development of your unborn child. During fetal development, specific parts of the lip and roof of the mouth fail to grow together. In some cases, a condition may be responsible for the development of the cleft. For most children, the cleft is thought to result from a complex combination of genetic and environmental factors.
Cleft lip and palate repairs are types of surgery used to correct this abnormal development and restore function to the mouth and lips, along with creating a more normal appearance. Dr Thendo can usually repair clefts through specialised plastic surgery techniques that will help to improve your child's ability to speak, eat, hear and breathe.
The surgery to repair a cleft of the lip or palate is highly individualized and is intended to close the cleft defect, and help your child function and develop normally. Cheiloplasty, or Cleft lip repair, includes the reconstruction of the lip to create a more normal appearance. This usually includes:
- The closure of the cleft, resulting in a scar located within or near the typical features of the upper lip.
- The formation of a cupid's bow.
- Establishing an adequate distance between the lips and nose
Clefts of the upper lip usually affect the shape of the nose and additional procedures can be recommended to:
- Restore the nasal symmetry and nostril shape
- Straighten and create the adequate length for the columella (the tissue that separates the nostrils)
The palate forms the floor of the nasal cavity and is also responsible for normal speech, so certain considerations must be made when repairing a cleft palate. These include:
- Separating the mouth and nasal tissues by closing the defect along its length.
- Establishing soft palate muscle function to promote normal speech
- Creating healthy relation of the soft palate to the auditory canal and Eustachian tube to allow for normal hearing
- Promoting the healthy growth and development of the upper jaw and teeth Repairing, when appropriate, any defects in the gum line to allow for permanent tooth eruption
Cleft lip repairs are typically performed between two and six months of age, depending on your child's health status. Cleft palate repairs are usually performed after cleft lip repair in a different surgery when the child is between the ages of 9 and 18 months old. Cleft lip and palate repair can be delayed to attend other, more serious conditions that may be present in the child, such as a heart or lung disorder.
Depending on the severity of the condition, Dr Thendo may recommend pre-operative interventions such as cleft lip taping, orthodontic moulding, or staged surgery techniques.
Other cleft-related procedures may be needed over time, including ear tubes to treat fluid buildup, bone grafting to repair the gum line, and dental or jaw surgery to improve bite relationships.